Provider Demographics
NPI:1992027585
Name:AMAYA, VIANCY JANIN (BS, CJ)
Entity Type:Individual
Prefix:
First Name:VIANCY
Middle Name:JANIN
Last Name:AMAYA
Suffix:
Gender:F
Credentials:BS, CJ
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1715 REGENTS ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-5403
Mailing Address - Country:US
Mailing Address - Phone:626-807-9352
Mailing Address - Fax:
Practice Address - Street 1:520 W PALMDALE BLVD
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-4229
Practice Address - Country:US
Practice Address - Phone:661-575-8395
Practice Address - Fax:661-272-2784
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-23
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner